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Medicare Q&A: Choosing the right prescription drug plan

Choosing the right prescription drug plan can be a headache when in the midst of enrolling for Medicare. Medicare enrollment runs from Oct. 15-Dec. 7. There are resources available to help enrollees choose which plan is right for them.
by Jaclyn Cosgrove Published: November 13, 2012
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What's the estimated cost if a person doesn't sign up?

It's estimated that an adult who has been on Medicare a few years takes 40 prescriptions a year, spending about $2,200 in drugs, Virdee said.

“So you can see what the savings are,” Virdee said. “If I had 40 prescriptions a year and 50 percent of them I could get at a preferred pharmacy for $0, I'd save a lot of money.”

How often can enrollees change plans?

Once you sign up for a plan, you stay in that plan for a year, unless you have a special circumstance, such as moving to an area where your plan isn't offered.

Virdee said if you find that your plan is set up in a discriminatory manner, you can file an appeal through the federal government to change plans.

A plan is discriminatory when it has a lack of appropriate drug classes to treat certain diseases, a lack of sufficient drugs in a therapeutic class, inappropriate tier placement that would discriminate against a group of beneficiaries, or missing drugs that would cause discrimination, according to the Centers for Medicare and Medicaid Services.

What are the resources available to help choose the best plan?

The state Insurance Department offers free Medicare counseling through the Senior Health Insurance Counseling Program. The program offers free help for Medicare beneficiaries, their representatives or people soon to be eligible for Medicare. The number is (800) 763-2828.

The Medicare website, medicare.gov, also has a significant amount of information about prescription drug plans. On the Medicare website, you can enter in the prescriptions you take and your ZIP code, and the website will calculate which plans are best for you. You can also call (800) MEDICARE, or (800) 633-4227 for assistance.

by Jaclyn Cosgrove
Medical and Health Reporter
Jaclyn Cosgrove writes about health, public policy and medicine in Oklahoma, among other topics. She is an Oklahoma State University graduate. Jaclyn grew up in the southeast region of the state and enjoys writing about rural Oklahoma. She is...
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